Tag Archive: doctors


I didn’t write anything last week.  I was involved in a few personal problems and was not able to spend as much time as usual on WordPress.  So, firstly, my apologies to all of the people whose blogs I usually visit but didn’t.

I’m back again this week – obviously – and here is the link to Madison’s page:

http://madison-woods.com/index-of-stories/untitled-071312/

If you click onto the little blue creature underneath the story, it will take you to a list of more 100-word stories.

Here are the photo prompt and my 100-word story:

It comes every night.  It starts with the black handles on the white wardrobe closing in on me until they’re about to crush me.  Then they move far away, and the room is enormous and I feel so small.  Then the handles come back again, and it keeps going until the dream starts.

The dream itself is terrifying.  I don’t know why.  Nothing happens in it.  But I’m terrified while I’m dreaming it.

There’s this tree.  It looks dead.  Then a buzzard comes and sits on it.  It just sits.  It doesn’t do anything…

Doctor?…  Doctor!…  Oh, my God!…  He’s dead!



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Hindsight – First Memory

Mum and I at the beach.

My foot’s stuck.  My fists clutch the cream cot’s flat, wooden bars.  I’ve done this before.  At least twice.  Maybe more.

The room is dim.  The blinds are down.  There’s grey light in the rectangle of the open door.  I can’t get that foot out!  I pull myself up on the right foot, my body off-balance.  I cling to the bars, find my balance…  then the left foot gets stuck!  Every time!

My right leg is shaking.  I try again.  Not quite.  The sheet and blanket are holding my foot.

To the right, there’s a bedside table.  Then the double bed.  This is Nan Dennis’ house.  We live in this room.  There’s a big mirror on the wardrobe door.  I lean to try to see myself.  I lean too far and nearly fall.  My left foot unfolds.  My body wobbles.  I hang on tight!  I crow with surprise.  How did I do that?  I’m standing up!  On both legs!

I look up with a joyful smile and see the silhouette in front of the grey light.  I know who that is!  That’s my Mummy!  I laugh to share my joy.  She doesn’t move.  She doesn’t talk.  She doesn’t tell me how clever I am.  She just stands in the doorway, her full skirt a triangle from waist to mid-calf.  And I’m happy and smiling and laughing and crowing…  And there’s no face.  Just the motionless silhouette…

***

A few years later, I tell my mother about the first time I stood up and how happy I was.  She frightens me in some way.  Perhaps she screams at me.  I know that she tells me I’m lying.  I can’t possibly remember back that far!

But I do.

***

Even more years later, I mention it again.  What’s wrong with Mummy?  There’s fear.  Hers and mine.  I don’t understand.  And I’m a liar again.  I can’t remember!  I was too young!

But I wasn’t.  And I do.

***

Later again, my aunt mentions my broken arm.  Broken arm?  Which arm?  The right.

I don’t remember.

How did it happen?  No-one knows.  I must have fallen down the kitchen step at Nan Dennis’ place.  We live in our own house now.  When a doctor saw it, the bones were already knitting together.  I was about fourteen months old.  A clean break.  He put sticking plaster around it.  The bones hadn’t moved so he didn’t have to break my arm again.

I’d been crying every night when I rolled on it.  I cried when I was having my bath.  Mummy said that it was around the time that I’d started having my bath in the big bathtub.  She thought that I was just frightened.  She put my baby bath in the big tub but I still cried.  One day, I tried to run away from her and she grabbed my arm.  I screamed.  Daddy was there that time.  So we went to the doctor’s.

I don’t remember.

***

Many, many years later, in hindsight, I wondered if it was true that no-one knew how I’d broken my arm.  Mummy’s mental health might have helped my arm to break.  How could no-one see that a child had a broken arm?  Why was Mummy so scared when I remembered the first time that I stood up?  Was she afraid that I would remember how my arm had been broken?

I don’t.

***

Louis Pasteur (1822-1895) in 1886.

Paul Bert, Physiologist and Minister of Public Instruction, demonstrates, in 1883, during a brilliant expose to the Academie on Pasteur, the main lines of the scholar’s work:  he says that Pasteur’s work can be classed in three series which constitute three great discoveries.  The first can be formulated like this:

Each fermentation is the product of the development of a special microbe.”

The second affirms:

“Each infectious illness is produced by the development in the organism of a special microbe.”

The third can be said like this:

“The microbe of an infectious illness, cultivated in certain determined conditions, is attenuated in its nocive activity;  from virus, it has become vaccine.”

Beyond Pasteur’s impressive scientific rigour, as his laboratory notebooks attest, a rigour doubled with a prodigious power for work, also beyond his very great intellectual flexibility, his faculty of being able to ceaselessly manipulate a collection of interchangeable hypotheses, it is his “ecological philosophy” which distinguishes him, his understanding of the connection between living beings and their natural environment, the ties between Man and Nature.  He elaborates this philosophy by stages, each of his works bringing him another stone to build it.  His studies on beer make him understand that the activity of microbes is influenced by their environment, and that microbian life is responsible for the permanent recycling of chemical substances in natural conditions, each bacterium has a role in the organization of the chain of life on Earth:

“If the microscopic beings disappeared from the surface of the Earth, it would be encumbered by animal and vegetal cadavers, by dead organic matter.  It is principally they who give its combustive properties to oxygen.  Without them, life would become impossible, because the work of death would be incomplete.”

The study of the silkworms and, later, human illnesses, made him understand that

“the nature of the life of all living beings is to resist the causes of destruction with which it is naturally surrounded”,

which introduces the notion of the possible coexistence of Man, Animal and microbes, as long as infection cannot declare itself, in particular environmental conditions.  Or, a pacific coexistence.

***

Louis Pasteur, Chemist.

Pasteur was neither Galileo, nor Newton, who attempted to explain the mysteries of the Universe, but he harmonised his activities with the preoccupations of his epoch, by submitting Nature to Science.  Until the XIXth Century, Society hadn’t had much to ask of the Man of Science, that Science that was the fief of the philosophical mind.  Pasteur would conciliate theory and practice throughout his whole life, his works would find their applications on the ground, in Industry, in the hospital, at home, in the city and in the country.  One could say, along with Claire Salomon-Bayet, that after Pasteur

“the whole of everyday life is kneaded with Pasteurism:  vaccinated children, boiled milk, sterilized rubber nipples, interdiction to spit on the ground, washed hands, controlled waters, disinfections, cut hair, short fingernails, municipal drains.”

One could add Pasteurized beer, Pasteurized butter, Pasteurized cheese, Pasteurized milk.  The list goes on and on…

Pasteur is also the judicious choice of men, of disciples whom he forms to his methods, and on whom he relies to transpose the laboratory researches everywhere.  According to Anne-Marie Moulin’s formula,

“the Pasteurians are perhaps Pasteur’s most impressive work”.

Chamberland, Duclaux, Roux, Grancher, Yersin, Loir, Calmette, Nicolle, Metchnikoff are all his direct heirs, who would in turn form the Pasteurians of the second generation, spreading throughout the world the scholar’s methods and doctrine.  Under its impulse, Doctor Calmette would create a Pasteur Institute in Lille, Adrien Loir would direct a Pasteur Institute in Tunis, Yersin would go to track down the plague in China, Nicolle would organize a bacteriological laboratory in Constantinople, Le Dantec would go to Brazil to study Yellow Fever.  The Pasteurian revolution has conquered the whole Earth.  The ideas and methods of Microbiology, by progressively changing the comportments of Medical Doctors and researchers, have changed the social comportments around illness.  By taking the microbe into the laboratory, and the laboratory into the hospital, Pasteur and the Pasteurians invented modern medical research.

If, today, we no longer die from diphtheria, rabies or tuberculosis, it is in great part thanks to this man who was passionate about Science, and to his everyday methodical application to his work.

***

Louis Pasteur (1822-1895) in 1886.

Roux is going to transform the Dispensary of the Vaccination Service into a veritable hospital of which the principle would be “to do everything to cut the chain of bacterial transmission”.  The rooms are individual, the personnel enters by an interior corridor and leaves by the balcony, the floor is easy to wash with plenty of water, the walls have rounded angles and are covered with an enamelled surface, the furniture is metallic, the nurses work with naked arms so as not to transmit germs from one patient to another with their sleeves…  A reporter from the newspaper Illustration testifies, in the number of 28 June 1890:

“Therefore let us enter in turn the Pasteur Institute […] and let us begin our visit by the important laboratories of ‘Microbie technique’, where, under the direction of Doctor Roux, series of pupils, most of them after their medical studies, receive in five or six weeks a supplement of instruction which is now indispensable for all Medical Doctors.  […]  In this so clean and so light workshop of the modern scholar, one would seek in vain the damp and dingy retreat, the smoky laboratory of the alchemist of the Middle Ages, with its powdery test-tubes and its stuffed crocodiles.  It is in full light and in all possible conditions of salubrity that one pursues today the discovery of the truth…”

***

In this institution devoted to research which is the Pasteur Institute, not only does one seek, but one finds.  After having worked on tetanos, Roux, assisted by Martin and Chailloux, develops a serum against diphtheria, whose efficacity is tested over several months on children stricken by this terrible illness, in Hopital Trousseau and in Hopital des Enfants-Malades.  He relies on the clinical diagnostic without waiting for the bacteriological diagnostic, and injects the children with the serum from the blood of horses on which he has studied the effects of immunisation, observing the great resistance of these animals to high doses of this illness’ toxins.

The German Behring, who would obtain the Nobel Prize in 1901, would enunciate with Kitasato the principle of the method in this year of 1890:  the serum of the blood of an animal, which is refractory or vaccinated with the help of weak doses of diphtheric or tetanic toxin, is injected into the receiving subject, and procures it immunity against this illness.  The serum of the vaccinated animal then possesses antitoxic properties.  The production of antidiphtheric serum then becomes a source of revenue for the Institute, permitting the financement of the researches.  On the initiative of Le Figaro, a subscription is opened both in France and in other countries for the installation of the Garches Domain and the stables necessary for the production of serum in horses.

The Hopital Pasteur is born.  Within three months, fifty thousand doses of vaccine are distributed free-of-charge.  Doctor Roux will make a Communication on diphtheria in 1894 at the International Congress on Hygiene in Budapest.  This historical Communication, which revolutionizes the History of Medicine, would be received with incredible enthusiasm and would obtain the definitive adhesion of the medical milieu, which can no longer either ignore or refuse this, at last, sure weapon against an illness which is decimating children.  The Concours medical, a periodical, mobilises the profession, exhorts the Medical Practitioners to learn the microbian technique, in particular serodiagnostic, so as to close the gap which separates the Practitioners who have been practising for a long time, from these “young people armed with a knowledge that is different from ours”.  The medical field is at last open to Pasteurism:  created exclusively for treating diphtheria, the Hospital would rapidly take on other infectious diseases:  smallpox, measles and scarlet fever.

In Spring 1895, the former Normaliens celebrate their School’s centenary.  They go to place a commemorative plaque on the little laboratory of the Rue d’Ulm, or rather the garret where one can only enter on one’s knees, and in which Pasteur installed, thirty-seven years earlier, his steamer, and made the first culture bouillons.  Then they go to visit the Institute.  They are received by Roux who has spread out on the tables the instruments “religiously conserved as witnesses to his Master’s progression”, the balloons of the Sea of Ice which gave such a great blow to the murderous theory of spontaneous generation, the test-tubes which were used for the studies on vinification, culture media, as well as an impressive collection of microbes.  Around noon, Pasteur has himself transported into the laboratory.  Roux then takes a microscope and proudly shows him the plague baccillus, which with that of diphtheria, completes their trophies as killers of microbes.

Shortly afterwards, Pasteur leaves to reside in Villeneuve-l’Etang, where Alexandre Dumas would come to chat with him.  He will die, stricken by an attack of uremia, on 28 September 1895.  The funeral will be grandiose.  It is Raymond Poincare, then Minister of Instruction, who will receive the coffin in the name of the Government, and would make a speech “of the highest eloquence”.  On this day, black tails and top hats would be side-by-side with tradesmen’s smocks and the caps of the labourer.  It is the time of reconciliations.  Celine Pouchet would write to Madame Pasteur:

“Madame, permit the daughter of Felix-Archimede Pouchet, whose fights with the illustrious scholar were so resounding, to associate herself with your immense pain and with the mourning of the whole of France.”

The embalmed body of Louis Pasteur is descended into its crypt at the Institute which bears his name, on 27 November 1896.  The French Scientist had become a laic saint.

***

To be continued.

Louis Pasteur (1822-1895) in 1886.

Thanks to a subscription opened in the New York Herald, four little Americans contaminated by rabies, belonging to working families, are able to come to Paris to be vaccinated.  People are coming from everywhere to be saved from the incurable ill.  By 1st March 1886, three hundred and fifty people have received the treatment.  Only one could not be saved:  Louise Pelletier.  Pasteur is then able to unveil his great project:

“My intention is to found in Paris a model establishment, without having any recourse to the State, with the help of international donations and subscriptions.”

In light of the results, the Academie des sciences names a Commission which unanimously adopts the project that an establishment for the treatment of rabies after being bitten be created in Paris, under the name of Institut Pasteur.

At this epoch, the 1870 War is still weighing heavily on the minds of all Peoples, despite the sixteen years that have passed.  There is great attention being given to this relentless fight which is being pursued against all illnesses.  A subscription is opened in France and other countries to finance the Institute.  The funds are to be received by the Banque de France, the Credit Foncier, the Tresoriers Payeurs Generaux and the Tax Collectors.  A Milan newspaper, La Perseveranza, which has opened a subscription, collects 6,000 francs.  Alsace, the homeland of the little Meister, mobilises, even though eleven months have gone by since the child’s recovery.  Alsace-Lorraine would bring in 43,000 francs.  The movement accelerates, money arrives from everywhere.

Meanwhile, nineteen Russians from the Smolensk province arrive in Paris.  The only French word that they know is “Pasteur”.  Attacked by a rabid wolf, most of them display horrible wounds.  A pope, surprised by the furious animal while on his way to church, had his upper lip and his right cheek ripped off, his face is only a gaping wound.  Five of these unfortunate people are in such a serious state that they have to be transported to the Hotel-Dieu.  Pasteur decides that he needs to do a double innoculation for them, for it is known that after certain bites of rabid wolves, all of the wounded had died.  The other Russians would remain in the laboratory of the Ecole normale.  These poor people are therefore to be seen, dressed in their tourloupe, on their way to their vaccination, their hands and heads covered in compresses, passing silently amongst the very diverse group of those bitten:  an English family, a Basque with his beret on his head, a French peasant woman, an Hungarian in his national costume.  People come from everywhere to be saved, for rabies means certain death after a terrible agony…

Alas, three of the Russians succumb;  the trip from Russia had been too long, the ill had had the time to install itself.  The return of the sixteen survivors is greeted in Russia with a quasi religious fervour and Tsar Alexander takes part in the foundation of the Pasteur Institute by giving 100.000 francs.

Pasteur’s renown grows even more.  The queue of patients lengthens:

“People in rags bitten near streams where they were trying to get a bone with meat still on it from a bulldog, elegant women with hair the colour of henna, that their King Charles Spaniel had scratched, elderly women wearing glasses, whose terrier had fought with a suspicious molossus, a lugubrious cortege that was comical in its implacable variety”,

reports Leo Claretie, from the magazine Coins de Paris.  Meanwhile, the money from the subscriptions is flowing in, the Official Journal does not stop publishing lists of generous donors for the creation of the Institute, where the names of the greatest fortunes mingle with a student’s savings, a working man’s salary.  Pasteur, ageing, his health declining, would say, during a Conference before the Societe philanthropique, in June 1866:

“It must be recognized that our century will have been, more than all the other centuries, concerned with the humble, those suffering and the very young.  Pursued by the fixed idea of helping them, three great things were needed:  we had to combat illness, poverty and ignorance.”

In May, a festival is organized in the Trocadero Palace in honour of Pasteur, subscriptions are still arriving.

On 14 November 1888, the Pasteur Institute is inaugurated in presence of President Sadi Carnot, who climbs the steps on the scholar’s arm.  There are Ministers there, representatives of the Diplomatic Corps, Members of the Academie de medecine and of the Institute.  Pasteur is tired.  His tongue is paralyzed, his speech hesitant.  Jean-Baptiste Pasteur has to read his father’s inaugural speech.  This speech is full of contained emotion, the elderly fighter is at the sunset of his life:

“Alas, I have the poignant melancholy of entering it [the Institute] as a man vanquished by time, who no longer has around him any of his Masters, nor even any of his companions from the fight.  If I have the pain of saying to myself:  they are no more, at least I have the consolation of thinking that all that we have defended together will not perish.  The collaborators and the disciples who are here share our scientific faith.”

The Institute is a great dispensary for the treatment of rabies, a study centre for virulent and contagious illnesses, and a teaching centre.  The course on microbia technique, directed by Emile Roux, lasts five weeks.  One pupil comments:

“Professor Roux was an outstanding Professor, endowed with an eloquence which did not seek its effect in words but captivated by the sobriety of the expression of the terms.”

The course unfolds directly inside the laboratory amongst the work instruments.  It takes place in the afternoon, so as to permit the Medical Doctors to continue to assume their charges.  The programme contains the knowledge of bacteria, the techniques of bacteriology, the experimentation on animals, the notions of virulence and of immunity, the practice of vaccinations.  The auditors come from all of the countries of the world, and all stages of the medical career are represented, from the young Intern right up to the Faculty Professor and the Head of Hospital Services.  The course in biological chemistry is taught by Duclaux;  the vaccination service, the principal axis of the work, is entrusted to Chamberland.  He has become specialized in the applications of his Master’s principles in everyday life, perfecting the “Chamberland Filter”, a column of porous porcelain which is fixed on the end of taps, and filters the germs and microbes contained in the water, efficiently avoiding the transmission of illnesses through piped water.  He also invents the autoclave, an hermetically sealed apparatus permitting the sterilization by heating of the laboratory instruments.  Finally, a newcomer, the Russian Metchnikoff, who studies white globules and their properties in the defence of organisms, is responsible for the Pasteurians’ personal laboratories.  Metchnikoff, “a zoologist who wandered into Medicine”, as he will call himself, is going to discover the deep mechanisms of the organism’s immunity to microbes.

To be continued.

Louis Pasteur (1822-1895) in 1886.

At the sight of the fourteen wounds of the little boy from Alsace who is walking with difficulty, he is suffering so much, Pasteur is deeply moved.  What to do?  Can he risk giving a child the preventive treatment which had succeeded on the dogs?  Heavy decision.  If only the cauterization had been done with a red-hot iron!  But what good is a cauterization with phenol twelve hours after the accident?  He makes an appointment for the child and his mother at five o’clock in the afternoon, after a seance at the Institut.  He wants to consult Vulpian, one of his colleagues on the Commission contre la rage, whose judgement he appreciates.  Vulpian gives his opinion that the experiments on the dogs are sufficiently conclusive to authorize hope for the same success with humans, and that it is more than probable that the child is condemned, if he is not treated.  If there is a chance of snatching the little boy from death, might as well seize it.

Escorted by Vulpian and Doctor Grancher, Pasteur goes to the child.  It is decided, with regard to the gravity of the bites, to innoculate that same evening with fourteen day marrow, the one with no virulence, then gradually progress to fresher marrows.  Pasteur, who is not a Medical Doctor, does not have the right to accomplish a medical act on the child, therefore it is Granger who will perform the injections.  As for him, he busies himself with all the rest:  he goes himself Boulevard Saint-Michel to buy a metallic bed for little Joseph Meister and he organizes a bedroom for the mother and child in the former Rollin College.  Each day, a more virulent marrow is innoculated.  Pasteur is worried, he doesn’t sleep, his wife reassures him:  the little boy seems, in fact, to be feeling better and better, and the scholar is able to write to his son-in-law:

“One of the greatest medical feats of the century is perhaps being prepared and you will regret not having seen it.”

The treatment lasts ten days, little Meister is innoculated ten times, finally, Pasteur goes as far as injecting, on 16 July 1885, at one o’clock in the morning, a one-day marrow, the one that gives rabies to rabbits every time, after only seven days of incubation.  On the evening of this redoubtable test, the little boy, after having embraced his “dear Monsieur Pasteur”, goes to bed calmly.  Pasteur would pass a cruel night.

Thirty days later, he will be able to sleep peacefully again, the child is saved.  And in 1886, he would be able to write to the little miracle boy:

“I received your last letter with great pleasure, because I saw that for writing, spelling and reasoning, you have made very marked progress.  […]  That by your work and your obedience to listen to your parents’ and your schoolmasters’ advice, you are making them all happy.”

He would say:

“I carry him in my heart, this dear child, who was for me, for long weeks, the subject of so many alarms.”

A Service for the preventive treatment of rabies after having been bitten must be organized, that is his project.  An event is going to force him to accelerate this organization.  Six little shepherds from the Jura have been charged in a field by a rabid dog.  While the children were running away, the biggest of them, then in his fifteenth year, Jean-Baptiste Jupille, faces it with his whip.  But in one bound, the dog throws itself on him and bites him on the left hand.  A fight then takes place, the child is again bitten, this time on the right hand, the whip falls into the grass.  He seizes the dog by the neck, calls his little brother to bring him the whip, then he muzzles the dog with the leather strip.  Then taking his wooden clog, he knocks out the animal which is frothing at the mouth and drags it along to a stream which flows along the field, and finally, drowns it.  The autopsy practised by two Veterinary Surgeons is clear, the dog is rabid.  Pasteur asks that the child come from the Jura.  But six days have already passed since the accident, is it still possible to save him?  He would save him like the little Meister.

Three months after the vaccination of the little boy from Alsace, on 26 October, before the Academie, Pasteur describes a new method for healing rabies.  It is the text of a combat, for he is attempting an experiment on Man without having succeeded in isolating the agent responsible for the illness.  But he is in a hurry, in a hurry to save other lives.  He cleverly ends his communication by the story of young Jupille’s adventure, leaving the learned assembly moved by the impression of this child who sacrificed himself to save his companions.  Bouley, the President of the Academie then speaks:

“We have the right to say that the date of the seance which is happening here at this moment shall ever remain memorable in the History of Medicine and forever glorious for French Science, since it is that of one of the greatest progresses which have ever been accomplished in the order of medical things:  the progress realized by the discovery of an efficient means of preventive treatment for an illness of which the centuries, in their succession since the beginning of time, have always leagued the incurability.”

As the chronicler of the newspaper Le Gaulois would report it:

“The passers-by who were traversing yesterday the vast solitudes of the interior courtyards of the Institute stopped in their tracks, astounded, upon hearing salvos of applause.”

After Jupille, it is Louise Pelletier, ten years old, bitten on 3 October, vaccinated from 9 November.  But it is too late, the ill had already made great progress in the little body.  Pasteur goes to the dying child’s bedside, Rue Dauphine, where he had found a lodging for her with her parents.  He will remain for the whole day to watch over her, and when all hope becomes lost, would say:

“I wanted so much to save your little girl!”

Then, on the stairs, he would burst into sobs.  His opposers react:

“It’s your virus-vaccine which awoke!”

A test is made on a rabbit:  the virus-vaccine is still attenuated.

To be continued.

Louis Pasteur (1822-1895) in 1886.

Pasteur’s first scientific contact with rabies dates from 11 December 1880:  a contaminated child is signalled at Sainte-Eugenie Hospital.  He looks for the microbe in the child’s saliva, but doesn’t find it.  Disappointed, he hands his test-tubes over to Doctor Roux who is testing attentuation techniques, while he himself continues to work on the virulence idea.  The experiments are high-risk for the scholars, the danger of contamination is everywhere, witness this scene:  one day, Pasteur has a rabid dog brought to him, wanting to take a saliva sample from it.  Two assistants take the frothing bulldog out of an iron cage, they throw a rope with a sliding knot around its neck and pick it up.  The dog which is struggling, furious, is stretched out on a table, its partly muzzled jaw slightly open.  The assistants hold the rabid dog still while Pasteur, a slim glass tube between his lips, his head leaning over the dog’s muzzle, sucks a few drops of frothy saliva into the tube.  The experiment is useless:  trial after trial, Pasteur determines that the saliva secretions of the dogs are not virulent enough, and that the microbe, after incubation in its victim’s body, becomes localised in the marrow of the spine.  More samples need to be taken.  Doctor Roux’ niece, Mary Cressac, reports:

“Roux, Chamberland and Thuillier are all leaning over the table.  If the animal gives them a jolt, if one of them cuts himself with his scalpel, if one little piece of rabid marrow penetrates the wound, then it would have been the perspective of weeks of anguishedly asking:  will rabies declare itself or not?  At the beginning of each seance, a loaded revolver was placed within reach…  if something unfortunate occurred to one of the three, the one of the other two with the most courage would shoot him in the head…”

Excessive dramatisation?  Probably not:  the unfortunate Thuillier, aged twenty-six, would be struck down by cholera in Alexandria, while accompanying a French Mission charged with studying the epidemic of this illness in Egypt.  Had he neglected a few of the prescriptions that Pasteur had written down for him before the Mission’s departure, or had they been found to have been too exaggerated because they were so minutious?  Whatever happened, the young man died within forty-eight hours, despite the presence at his side of Roux and a battalion of French and Italian Doctors who treated him until the end.  Doctor Koch, who was also in Alexandria, nailed two wreaths on the coffin, saying:

“They are modest, but they are of laurier;  they are those given to the glorious.”

Roux puts together a protocol.  With potassium, he dries the spinal marrow of rabbits contaminated with rabies, suspended in glass bottles.  The technique is efficient.  An infected marrow dried in this position for fourteen days becomes inactive.  Extracts of spinal marrow dried for fourteen, then for thirteen, then for eleven days are injected into dogs and produce in them a state that is refractory to the illness, which is confirmed by a last injection of virulent marrow, which has then become without danger for the animal.  Experiments on a big scale have to be done…  This means money.  Pasteur asks for the meeting of a Commission from the Ministry of Instruction.  After enquiry, this Commission considers that Pasteur’s laboratory at the Ecole normale has become “master of the refractory state”;  which means that the animals vaccinated by the contaminated marrow of rabbits have all become refractory to rabies.  A former property of the Imperial Family, at Villeneuve-l’Etang, to the West of Paris, is bought by the State and affected to Pasteur and his team to perform experiments on a greater scale.  Packs of rabid and healthy dogs are brought there from the Pound and locked up in the former stables, transformed into kennels by the Scientists.  Day and night, the animals’ whining and barking can be heard, which creates some conflict with the neighbours, who are worried about the presence of rabid guard dogs.  The scholar and his team move in, basic repairs are made in the Commons.  A Financier who is passing through would say, astounded by the Spartan installation:

“It’s not the comfort that is going to get in your way”.

Pasteur pursues two series of experiments in parallel on one hundred and twenty-five dogs.  The first consists in making preventive innoculations to render the dogs refractory to rabies, the second is to prevent rabies from erupting in dogs which have been bitten or innoculated.  The results are way beyond the scholar’s expectations.  He knows that he is on the right path, but he doesn’t know how his procedure “functions”.  During a seance of the Academie francaise where work is being done on the dictionary, Pasteur, entirely absorbed by his subject, is not listening and scribbles on a paper that has come into his hand:

“I am led to believe that the rabies virus must be accompanied by a matter which, by impregnating the nervous system, makes it improper for the culture of the figured microbe.  From there, vaccinal immunity.  If this is so, the theory could well be very general.  This would be an immense discovery.”

One point is however established:  preventive innoculation.  But the months pass by without him being able to understand how the antirabies vaccination works.

***

One Monday morning, 6 July 1885, he sees arriving in his laboratory a little boy from Alsace, aged nine, Joseph Meister, bitten two days before by a rabid dog.  His mother is with him.  She tells him all about the accident.  Her child was going alone to school on a little pathway when a dog leaped onto him.  Knocked down, incapable of defending himself, the child only thought to cover his face with his hands.  A mason, who had seen from a distance what was happening, rushed over, armed with an iron bar, and obliged the furious dog to let go by hitting it repeatedly, then he had lifted up the little Meister covered in saliva and blood.  The dog went home to its master, the grocer Theodore Vone, and bit him, without however its teeth succeeding in penetrating his clothes.  The grocer killed the dog by shooting it.  The autopsy revealed that its stomach was filled with hay, straw, pieces of wood.  Doctor Weber, from Vulle, after having cauterized the wounds with phenol, advised the Meisters to take the train to Paris.

To be continued.

Louis Pasteur (1822-1895) in 1886.

In 1896, Emile Duclaux would comment:

“To everybody’s surprise, even Pasteur’s, almost all of these chickens (vaccinated) would resist, while the new chickens coming from the market would succumb […]  What spirit of divination prodded Pasteur to knock at this door which was asking only to be opened?”

Pasteur in fact again finds the effects of the ageing of the illness already noted in the corpuscules of the silkworm, and he again sees as well the story of Jenner:  in 1796, Edward Jenner had innoculated Man with a cow illness, vaccine, thereby preserving him from smallpox.  But between Jenner and Pasteur, there had been the discovery of microbes.  Further, with the chickens of Summer 1879, an unexpected and very important phenomenon was appearing in the course of the manipulation:  resistance to virulence.  This new fact initiates for Pasteur and his pupils a study programme, that of the virus-vaccines.

The second act takes place at Maison-Alfort.  During the researches on chicken cholera, those on anthrax continue.  If the guinea pig is a living reservoir transporting chicken cholera, the scholar determines that it is the earthworms which, in the countryside, play this role for anthrax.  By bringing soil to the surface, they bring the germs of animals who have died from anthrax and have been buried in the pastures by the peasants.  The healthy animals then graze on grass mixed with germs and in turn perish.  It is again Doctor Toussaint who sets off the researches of Pasteur and his pupils.  Toussaint announces that he has succeeded in vaccinating sheep thanks to a culture of anthrax submitted to heat.  Pasteur asks the Minister of Agriculture for the authorisation to make some tests on Toussaint’s vaccinating liquid at the Ecole veterinaire in Maison-Alfort:  it is a failure, the innoculated sheep all die.  The attenuation obtained by Toussaint is very real, but not definitive, the anthrax microbe, momentarily weakened, had become virulent again.  However, it is the right direction, and the team begins laboratory trials.  It finds the temperature and the limit of the length for attenuating the virulence of the bacteria, without removing from them a certain possibility for multiplying.  At the Academie, on Monday 28 February 1881, Chamberland, Roux and Pasteur co-sign a communication on the anthrax vaccine and the whole table of virulences.

The third act then takes place in the country, at Pouilly-le-Fort, near Melun.  This time, Pasteur is directing the play.  Hippolyte Rossignol, Veterinary Surgeon, suggests a farm as the place of action.  The actors will be sheep.  Rossignol has taken care of everything:  contacts have been made with the local aediles, with the Societe d’Agriculture in Melun.  This Society is presided by the Baron de La Rochette, a friend of the Sciences, and it has been placed at the disposition of the scholar and his team along with its flock of sixty sheep.  Senators, conseillers generaux, Farmers, Veterinary Surgeons, Medical Doctors are all there.  The Press too has been invited.  Pasteur writes the programme of the day, a great number of copies of which are distributed.  Certain sheep are to be vaccinated, others not, and it will be predicted to the audience right to the last sheep how many will die when they are later put in contact with the anthrax microbe!  The preliminary experiments in the laboratory and in Alfort have been rehearsals, but certain colleagues have not been convinced.  The Scientist wants to strike hard, take risks, and cover in ridicule his adversaries, like Colin.  Further, there is suspense:  the injections are made on 5 May 1881, the results will only be known on 2 June.  They return to Paris.  On 2 June 1881, before leaving for Pouilly-le-Fort, the Master writes to his disciples:

“Last Tuesday, we innoculated all the sheep, the vaccinated and the unvaccinated, with very virulent anthrax.  And the telegramme (from Rossignol) announces that, when we arrive today at two o’clock, all of the unvaccinated ones will be dead.  As for the vaccinated ones, they are all standing.  The telegramme ends with the words:  stunning success.  There is joy in the laboratory and at home.  Rejoice my dear children.”

But a vaccinated ewe dies on 4 June.  Is this a defeat?  No, the autopsy shows that the death was provoked by that of the foetus that the ewe was carrying.

The curtain falls, Pasteur can bow to the public.  The experiments of Pouilly-le-Fort will resound prodigiously.  Henry Bouley, from La Revue Scientifique, will write:

“Pouilly-le-Fort, as famous today as all the great battlefields, where Monsieur Pasteur, a new Apollo, did not fear to launch oracles, more certain of success that the God of Poetry could ever be.”

***

Among his childhood memories, Pasteur counted a terrible one.  The event went back to the month of October 1831.  Terror was spreading throughout the Jura because of a rabid wolf which was biting animals and people along its route.  The people bitten on their hands and heads were succumbing to rabies, with atrocious suffering.  In the Communes of Villers-Farlay, Ecleux and Mouchard alone, there had been eight victims.  The young Louis had seen cauterized with a red-hot iron, in the forge situated a few metres from his father’s house, the wounds of an inhabitant of Arbois named Nicole, who had been attacked by the wolf.  Nicole had not survived.

For years, the fear of this rabid wolf survived throughout the whole region.  This ill was reputed incurable, and, on top of that, the patient bitten by an animal was often finished off by members of his or her own family.  In 1810, a Philosopher had asked the Government to adopt the following Law:

“It is forbidden, on pain of death, to strangle, suffocate, bleed from all four members, or in any other way cause the death of an individual suffering from rabies…”

In 1816, only fifteen years before Pasteur had seen the blacksmith’s red-hot poker burn Nicole’s flesh, the newspapers were recounting the death of an unfortunate rabies sufferer suffocated between two mattresses.  On the subject of this mercy killing, they were saying in the Press of the epoch:

“So it is the duty of the Doctor to repeat that this illness cannot be transmitted from human to human, and that there is no danger in caring for those suffering from it.”

Some people who had been bitten by rabid dogs were submitted to the bite of a viper to try to neutralize the virus.  A cruel and useless ordeal.

To be continued.

Louis Pasteur (1822-1895) in 1886.

On 11 March 1878, an elderly gentleman, Charles-Emmanuel Sedillot, former Director of the Ecole du service de sante militaire in Strasbourg, is reading to the Academie des sciences a note entitled De l’influence des travaux de Monsieur Pasteur sur les progres de la chirurgie.  He says that they must stop the debates of no interest about the terms to be employed to designate the little organisms which are then forming a whole new world that can be seen under the microscope:  “microzoaires”, “microphytes”, “bacteria”, “bacteridies”, “vibrions”, “infusories”, “ferments”…  After exchanges with the Medical Doctor and Lexicographer Emile Littre, he proposes the word “microbe”, a term which will rapidly become generalized.  It is on the following 30 April, before this same Academie, that the famous communication La theorie des germes et son application dans la medecine erupts.  It is signed Pasteur, Joubert and Chamberland.  After expounding on numerous studies, including that of the anthrax bacterium, it asks the questions:

“How can septicaemia be spread through the air, since this long translucent thread which crawls in the patient’s blood, and is now baptised septic “microbe”, is killed by this air?  How can blood exposed to oxygen become septic by dusts contained in the air?”

Pasteur’s demonstration is brilliant, incisive, as always.  He shows that in a drop of blood filled with septic vibrions, only those in the superior layer of this drop are killed on contact with the air, protecting from the oxygen by their minuscule cadavers their brothers in the inferior layers which multiply by dividing, then gradually pass to the state of germs, change their form, metamorphose while waiting for the right time, now insensitive to the air.  In the eyepiece of the microscope, one then only sees a barely visible dust of brilliant spots.

“And there it is formed, living the latent life of germs, no longer fearing the action of oxygen, there, I say, is the septic dust.  […]  we can understand the seeding of putrescible liquids by the dusts of the atmosphere, we can understand the presence of the putrid illnesses on the surface of the Earth.”

A simple experiment should be meditated by the Surgeons:  after having practised, with a slash of the scalpel, a little opening in the thickness of the tissues of a leg of lamb, Pasteur makes a drop of the septic vibrion culture penetrate it.  The microbe goes to work, the flesh gangrenes.  He tells them:

“This water, this sponge with which you wash the wounds, deposit germs which, as you can see, have an extreme facility for propagation in the tissues and inevitably lead to the death of the people on whom you have operated in a very short time if the life, in these members, does not oppose the multiplication of these germs.  But, alas!  how many times is this vital resistance powerless, how many times do the wounded person’s constitution, his weakened state, his morale, the bad condition of his dressings oppose only an insufficient barrier to the infinitely small beings with which you have unwittingly covered him in the part of him that is damaged!  If I had the honour of being a Surgeon, […] I would use only dressings, bandages, sponges which had been previously exposed in an air brought to the temperature of 130 to 150 degrees Centigrade, I would use only water which has been submitted to a temperature of 110 to 120 degrees Centigrade.”

Pasteur even goes through the smallest details, none of them seems negligeable to him.

Louis Pasteur's friend, the Physiologist Claude Bernard.

The germ theory has taken off, nothing more will stop it despite the blind resistance of the doctors, but it will only be established at the price of many efforts.  Nevertheless, in 1882, four years after the birth of the word microbe, mortality falls from fifty to five per cent for surgical operations, this time surrounded by precautions of hygiene and antiseptic methods.  In the maternity hospitals where there were between one and two hundred deaths of mothers for one thousand births, the figures fall to less than three for one thousand.  Everywhere, hygiene grows, develops and finally takes its place in public preoccupations.  It is recounted that, a few years before, Pasteur had complained in front of Claude Bernard about the type of endless discussion that was opposing him at the Academie de medecine to the believers in spontaneous generation.  Claude Bernard is supposed to have replied:

“Something of you will remain.  This morning, my Surgeon Gosselin came to probe my bladder.  He was accompanied by a young intern, Guyon, who follows your doctrines.  Gosselin washed his hands after having probed me.  Guyon washed his before.”

***

It is in the Summer of 1879 that Pasteur has a new rush of genius.  The Chemist’s researches have then been moved from the town to the country where chicken cholera is ravaging farmyards.  Pasteur is going to study the chickens and their microbes in this 1879 Summer.  While observing these birds, Pasteur is going to commit a technical fault which, paradoxically, is going to open the way to an extraordinary discovery.

The first act of the play opens in the laboratory of the Ecole normale.  They are waiting for a parcel from a province, containing the head of a cock which has died from cholera, sent to Pasteur by a Toulouse Veterinary Surgeon, Doctor Toussaint.  The Doctor is unsuccessfully trying to multiply the illness in culture media.  He is asking advice.  Pasteur is interested.  He wants to obtain the proliferation of the microbe in test-tubes, to understand the epidemics which appear or disappear according to the seasons.  He also wants to understand how a microbe can be mute for a long time, while still remaining alive.  He multiplies the seedings and notes that a seeding every twenty-four hours conserves the microbe’s virulence.  He notices that an injection into a guinea-pig does not affect the little rodent, but causes a simple abcess, whose liquid is on the other hand fatal to the chickens.  The idea of a living reservoir develops.

The holidays are here, Summer 1879;  the team is resting;  the virulent cultures are abandoned in their test-tubes.  Back from holidays, they begin to innoculate with these aged cultures.  And, the chickens innoculated with this cholera are ill, but most of them don’t die.  General astonishment!  Since these chickens are there, might as well use them again.  This time, they are injected with new, virulent cultures…  and they resist!  The principle of the vaccine is in the process of being born.

To be continued.

Louis Pasteur (1822-1895) in 1886.

Meanwhile, in France, nothing has changed.  The great medical chiefs have absolute confidence in themselves, and despite the brilliant results that Joseph Lister continues to obtain in Edinburgh, the principle of asepsis is disdainfully rejected.  Today, one can look back sadly at the number of lives which would have been saved if Pasteur’s, Lister’s and Guerin’s advice on elementary hygiene had been adopted as soon as it was known.  Pasteur, a great one for shaking up ideas, outdoes himself in communications before the Academie de medecine, and battles on all fronts:

“If one examines a probe under the microscope, one finds on its surface ridges and valleys inside which are lodged dusts that the most minutious washing cannot completely remove.  The flame allows the entire destruction of these organic dusts.  So, in my laboratory where I am enveloped in germs of all sorts, I do not use an instrument without firstly passing it through the flame.”

Alas, for the eternal supporters of spontaneous generation, the germ is born in the patient, it does not come from the instruments.  Therefore, people continue to die under the Surgeon’s scalpel.

The room where one gives birth seems to the women of the people to be death’s antechamber.  They still recall in horror that, inside the Hopital de la Maternite de Paris, from 1st April to 10 May 1856, out of three hundred and forty-seven women having given birth, there were sixty-four deaths.  The hospital had to be closed, and the survivors were obliged to take refuge in the Hopital Lariboisiere, where almost all of them succumbed, pursued – it was said – by the epidemic.  Eight years later, in 1864, out of one thousand, five hundred and thirty women having given birth, there were three hundred and ten deaths.  It was another thirteen years before Tarnier, then at the head of the Maternite de Paris, put into practice Lister’s techniques, asepsis techniques which had already been adopted by Russia, Holland, Germany, Austria and Denmark, with the greatest success.  Doctor Roux evokes Pasteur’s state of mind during these incessant battles that he was having with the Doctors.  He is not content with just giving advice, criticizing (and, in passing, making permanent enemies among those who place their professional vanity higher than scientific progress), he works ceaselessly to demonstrate that which he is advancing.  He searches, he experiments and improves the technique of the culture of microbes in the laboratory, getting them to reproduce in his flasks, his test-tubes, in different nutritive media, such as the beer yeast bouillon.  This technique was initiated by a young German Medical Doctor who himself admitted being stimulated by Pasteur’s studies.  His name is Doctor Koch.  Assisted by his wife and daughter, this country Doctor, living in a little village in an eastern province, will bring direct proof that a defined type of microbe is at the origin of a defined type of illness, by developing a pure culture containing only one bacterial layer.  It is with this method that he would succeed, in 1882, in isolating the tuberculosis bacillus.

In Paris, Pasteur goes into hospitals, takes samples from sick people, with his sterilized test-tubes and pipettes.  When he is warned of the dangers of contagion, he replies:

“Life amongst danger is a real life, it is a great life, it is a life of sacrifice, it is a life of example, that which fecunds!”

He roars with holy anger against the Doctors who continue to dissert without acting:

“I’ll make them move!  They must come round to it, whatever it takes!”

In June 1877, he notices under his microsope a long filament, crawling and flexible, translucent to the point of easily not being seen and which, in his own words, “pushes aside the globules of blood like a serpent pushes aside grass in the bushes”.  It is the septic vibrion, discovered inside the deep veins of an asphyxiated horse.  From the peritone where it is rife, this moving thread passes into the blood after death.  A drop of this infected blood innoculated into another animal immediately provokes septicaemia in it.  But there is a problem:  this minuscule killer cannot stand oxygen, which destroys it.  How can it then act and make victims by passing through the air?  The Chemist cultivates the vibrion in a vacuum and in the presence of carbonic gas.  His experience in the seeding and dissemination of beer yeasts, and those of the silkworm maladies, allow him to work by comparisons.  As Emile Duclaux says:

“To the question:  is it a virus?  Is it a microbe?  Pasteur is better placed than anyone else to find an answer.  From his studies on beer, from his fights with his contradictors, he is armed with a technique already formed, with the knowledge and the manipulation of microbian species.”

In fact, the “so-called Chemist” permits himself to give courses on Methodology to his enemies.  Amedee Latour, a journalist from Union Medicale, who regularly follows the seances at the Academie de medecine, reports, amused, one of Pasteur’s clashes with a contradictor.  It is again a believer in spontaneous generation, but this time it is not a Medical Doctor, it is a Veterinary Surgeon, Colin,  professeur d’ecole from Alfort.  Colin describes his experiment:  he had innoculated the leg of an animal with blood from another animal which had died from anthrax.  The lymph gland nearest to the injection swelled, the innoculated animal is in turn ill, but Colin does not find bacteridies in the gland, or in the animal’s blood, and yet, it is infectious.  Pasteur asks him how he had examined the glandular liquid.  Colin replies with the microscope of course.  Pasteur tells him that, as his microscope only shows things four or five hundred times their size, this was not the right way to go about it.

“It was four or five square metres of your glass plate over which you should have passed your microscope to be able to perceive the one and only bacteridie which had escaped […] when you examined your gland.  It is by the culture of the bacteridies that one is able to arrive at the certitude of the opinions that I have advanced on anthrax.”

And the journalist concludes:

“What a valiant fighter Monsieur Pasteur is!”

To be continued.

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